ATI LPN
ATI Pediatrics Proctored Exam 2023 with NGN
1. When using the Ballard gestational assessment tool on a newborn, which of the following tests should be performed after the first hour of birth, allowing the newborn to recover from the stress of birth?
- A. Arm recoil
- B. Square window sign
- C. Scarf sign
- D. Popliteal angle
Correct answer: A
Rationale: The correct answer is Arm recoil. Arm recoil is slower in healthy but fatigued newborns after birth, making it best elicited after the first hour of birth when the baby has had time to recover from the stress of birth. This assessment helps evaluate neuromuscular maturity in newborns and is more accurate when performed after the initial recovery period. The other choices, Square window sign, Scarf sign, and Popliteal angle, are not specifically assessed using the Ballard gestational assessment tool and do not relate to the recovery period after birth.
2. A nurse is determining ways to address ethnic diversity among clients being provided care. Which action would be the most direct way for the nurse to do this?
- A. Explain how cultural backgrounds influence health beliefs and practices.
- B. Provide culturally sensitive care that respects clients' traditions.
- C. Listen to the life stories of clients to understand their cultural influences.
- D. Participate in cultural competency training and workshops.
Correct answer: C
Rationale: Listening to the life stories of clients is an effective way for nurses to understand the cultural influences that shape their beliefs and practices. By actively listening, nurses can gain insight into the clients' backgrounds, values, and preferences, allowing them to provide more personalized and culturally sensitive care. Choices A, B, and D are not as direct as listening to the life stories of clients. While explaining how cultural backgrounds influence health beliefs and practices is important, directly listening to clients' life stories provides a deeper understanding of their individual cultural influences.
3. A client at 40 weeks of gestation is experiencing contractions every 3 to 5 minutes, becoming stronger. A vaginal exam by the registered nurse reveals the client's cervix is 3 cm dilated, 80% effaced, and -1 station. The client requests pain medication. Which of the following actions should the nurse prepare to take? (Select all that apply)
- A. Provide ice chips.
- B. Insert an indwelling urinary catheter.
- C. Administer opioid analgesic medication.
- D. Provide ice chips.
Correct answer: C
Rationale: During labor, effective pain management is crucial. The nurse should assist the client with patterned breathing techniques to help manage pain and administer opioid analgesic medication as ordered. Providing ice chips is a comfort measure but does not directly address pain relief. Inserting a urinary catheter is not typically indicated at this stage of labor unless there are specific medical indications, such as the need to closely monitor urine output. Therefore, the correct action for the nurse to prepare to take in this scenario is to administer opioid analgesic medication.
4. A healthcare provider is preparing to administer a dose of clindamycin. Which of the following should the provider assess first?
- A. Allergy history
- B. Vital signs
- C. Renal function
- D. Liver function
Correct answer: A
Rationale: When preparing to administer clindamycin, assessing the patient's allergy history is crucial as clindamycin can cause severe allergic reactions. This assessment helps identify any potential risks related to allergies and enables the healthcare provider to take necessary precautions. Vital signs, renal function, and liver function are also important assessments before administering medications, but in this case, checking for any history of allergies takes priority due to the risk of severe allergic reactions associated with clindamycin.
5. The client has received 250 ml of 0.9% normal saline through the IV line in the last hour. The client is now tachypneic and has a pulse rate of 120 beats/minute, with a pulse volume of +4. In addition to reporting the assessment findings to the healthcare provider, what action should the nurse implement?
- A. Discontinue the IV and apply pressure at the site.
- B. Decrease the saline to a keep-open rate.
- C. Increase the rate of the current IV solution.
- D. Change the IV fluid to 0.45% normal saline at the same rate.
Correct answer: B
Rationale: In this scenario, the client is showing signs of fluid overload with tachypnea and a high pulse rate. Decreasing the saline to a keep-open rate is appropriate to prevent further fluid volume excess. This action allows for IV access to be maintained while reducing the fluid administered, helping to manage the symptoms of fluid overload.
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